<div id="steps">
<?php
echo form_open('user/user');
?>
	<form>
		<fieldset class="step">
			<p>
				<label>Nama Lengkap</label>
				<input id="nama" name="nama" type="text" value="" tabindex="1" />
			</p>
			<p>
				<label>Nama Panggilan</label>
				<input id="nama" name="nama" type="text" value="" tabindex="1" />
			</p>
			<p>
				<label>Jenis Kelamin</label>
				<input type="radio" name="sex" value="male" /> Laki-laki<br />
				<input type="radio" name="sex" value="female" /> Perempuan
			</p>
			<p>
				<label>Angkatan/Batch</label>
				<input type="radio" name="angkatan" value="male" /> Angkatan<br />
				<input type="radio" name="angkatan" value="d" /> Yang lain:<br />
				<label>&nbsp</label><input type="text" name="ang" />	
				
			</p>
			
			<p>
				<label>Tempat Lahir</label>
				<input id="nama" name="nama" type="text" value="" tabindex="1" />
			</p>
			<p>	
				<label>Tanggal Lahir</label>
				<input style="width: 30px;margin-right:5px;" id="element_4_2" name="element_4_2" size="2" maxlength="2" value="" type="text">
				<input style="width:30px;margin-right:5px;" id="element_4_1" name="element_4_1" size="2" maxlength="2" value="" type="text">
				<input style="width: 80px;" id="element_4_3" name="tanggal_lahir" size="4" maxlength="4" value="" type="text">

				<img id="cal_img_4" src="<?=base_url();?>images/form/calendar.gif" alt="Pick a date.">	
			
				<script type="text/javascript">
					Calendar.setup({
					inputField	 : "element_4_3",
					baseField    : "element_4",
					displayArea  : "calendar_4",
					button		 : "cal_img_4",
					ifFormat	 : "%B %e, %Y",
					onSelect	 : selectDate
					});
				
				</script>
			</p>
			<p>
				<label>Jenis Usaha</label>
				<input id="nama" name="nama" type="text" value="" tabindex="1" />
			</p>
			<p>
				<label>Omset Sekarang</label>
				<input id="nama" name="nama" type="text" value="" tabindex="1" />
			</p>
			<p>
				<label>Pekerjaan</label>
				<input type="radio" name="pekerjaan" value="male" /> Pelajar/Mahasiswa<br />
				<input type="radio" name="pekerjaan" value="d" /> Karyawan Swasta<br />
				<label>&nbsp</label>
				<input type="radio" name="pekerjaan" value="d" /> Wiraswasta<br />
				<input type="radio" name="pekerjaan" value="d" /> Pegawai Negeri/BUMN<br />
				<label>&nbsp</label>
				<input type="radio" name="pekerjaan" value="d" /> Yang lain:<br />
				<input type="text" name="ang" />
			</p>
			<p>
				<label>No Telepon/Handphone</label>
				<input id="nama" name="nama" type="text" value="" tabindex="1" />
			</p>
			<p>
				<label>No Telepon Darurat*</label>
				<input type="radio" name="darurat" value="male" /> Istri/Suami<br />
				<input type="radio" name="darurat" value="d" /> Kakak<br />
				<label>&nbsp</label>
				<input type="radio" name="darurat" value="d" /> Adik<br />
				<input type="radio" name="darurat" value="d" /> Orang Tua<br />
				<label>&nbsp</label>
				<input type="radio" name="darurat" value="d" /> Yang lain:<br />
				<input type="text" name="ang" />
			</p>
			<p>
				<label>Hubungan * Apa hubungan Anda dengan Pemilik Nomor Telepon Darurat</label>
				<input id="nama" name="nama" type="text" value="" tabindex="1" />
			</p>
			<p>
				<label>Alamat Email*</label>
				<input id="nama" name="nama" type="text" value="" tabindex="1" />
			</p>
			<p>
				<label>Ukuran T-Shirt*</label>
				<input type="radio" name="kaos" value="male" /> S<br />
				<input type="radio" name="kaos" value="d" /> M<br />
				<label>&nbsp</label>
				<input type="radio" name="kaos" value="d" /> L<br />
				<input type="radio" name="kaos" value="d" /> XL<br />
				<label>&nbsp</label>
				<input type="radio" name="kaos" value="d" /> XXL<br />
				<input type="radio" name="kaos" value="d" /> XXXL<br />
			</p>
			<p>
				<label>No Telepon Darurat*</label>
				<input id="nama" name="nama" type="text" value="" tabindex="1" />
			</p>
			<p>
				<label>Alamat Rumah</label>
				<textarea id="element_2" name="alamat" ></textarea> 
			</p>
			<p>
				<label>Kota*</label>
				<input id="nama" name="nama" type="text" value="" tabindex="1" />
			</p>
			<p>
				<label>Twitter Account (ID Twitter Anda. ex : @ECampIndonesia. Kosongkan jika belum punya.</label>
				<input id="nama" name="nama" type="text" value="" tabindex="1" />
			</p>
			<p>
				<label>Referensi*</label>
				<input type="radio" name="referensi" value="male" /> Majalah<br />
				<input type="radio" name="referensi" value="d" /> Surat Kabar<br />
				<label>&nbsp</label>
				<input type="radio" name="referensi" value="d" /> Website<br />
				<input type="radio" name="referensi" value="d" /> Twitter @ECampIndonesia<br />
				<label>&nbsp</label>
				<input type="radio" name="referensi" value="d" /> Yang lain:<br />
				<input type="text" name="ang" />
			</p>
			<p>
				<label>Saya ingin mendapatkan PEGASUS - PROMO ECAMP HARGA KHUSUS.</label>
				<select id="element_7" name="element_7" tabindex="2"> 
					<option value="" selected="selected">Ya</option>
					<option value="Manager" >Tidak</option>
				</select> 
			</p>
			<p>
				<label>Saya ingin mendapatkan informasi seputar Ecamp.</label>
				<select id="element_7" name="element_7" tabindex="2"> 
					<option value="" selected="selected">Ya</option>
					<option value="Manager" >Tidak</option>
				</select> 
			</p>
			<p class="submit">
				<button id="registerButton" type="submit">Simpan</button>&nbsp;
				<button id="registerButton" type="reset">Reset</button>&nbsp;
				<button id="registerButton" type="submit">Kembali</button>
			</p >

		</fieldset>
	</form> 
<?php
echo form_close();
?>
</div>